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[PMID]:29505518
[Au] Autor:Zhang S; Huang Q; Xu B; Ma J; Cao G; Pei F
[Ad] Endereço:Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Título:Effectiveness and safety of an optimized blood management program in total hip and knee arthroplasty: A large, single-center, retrospective study.
[So] Source:Medicine (Baltimore);97(1):e9429, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Little has been published on blood management in total hip and knee arthroplasty (THA and TKA, respectively) patients focusing on both hematopoiesis and hemostasis. Our aim was to explore the effectiveness and safety of an optimized blood management program in THA and TKA patients in a large, single-center, retrospective study.We retrospectively reviewed consecutive primary unilateral THA and TKA patients' data at our institution through the National Health Database. They were divided into 3 groups according to an optimized blood management program: group A-combined use of intravenous and topical tranexamic acid (TXA); group B-use of recombinant human erythropoietin (rHuEPO) and iron supplements in addition to treatments in group A; group C-use of additional multiple boluses of TXA in addition to treatments in group B. The primary outcomes were hemoglobin (Hb) drop and calculated total blood loss (TBL). Other outcome measurements such as transfusion rate, postoperative length of stay (PLOS), venous thromboembolism (VTE), and mortality were also compared.From 2014 to 2016, a total of 1907 unilateral THA (986 in group A, 745 in group B, and 176 in group C) and 1505 unilateral TKA (795 in group A, 556 in group B, and 154 in group C) procedures were conducted at our institution. The Hb drop, calculated TBL, and PLOS in group C were significantly lower than those in groups A and B for THA and TKA patients. The transfusion rate in group C was also significantly less than in groups A and B for THA patients, while it was similar in groups A and B for TKA patients. No patients in group C received a transfusion. A significant difference was not detected in the incidence of deep vein thrombosis. No episode of symptomatic pulmonary embolism or all-cause mortality occurred within 30 days postoperatively.The current retrospective study suggests that for patients receiving primary unilateral THA or TKA, multiple boluses of intravenous TXA combined with topical TXA, rHuEPO, and iron supplements can reduce the calculated TBL, Hb drop, transfusion rate, and PLOS without increasing the incidence of VTE or mortality.
[Mh] Termos MeSH primário: Anemia/tratamento farmacológico
Antifibrinolíticos/administração & dosagem
Perda Sanguínea Cirúrgica/prevenção & controle
Eritropoetina/uso terapêutico
Ferro/uso terapêutico
Oligoelementos/uso terapêutico
Ácido Tranexâmico/administração & dosagem
[Mh] Termos MeSH secundário: Administração Intravenosa
Administração Tópica
Adulto
Idoso
Anemia/etiologia
Artroplastia de Quadril/efeitos adversos
Artroplastia do Joelho/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Proteínas Recombinantes/uso terapêutico
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 0 (Recombinant Proteins); 0 (Trace Elements); 11096-26-7 (Erythropoietin); 6T84R30KC1 (Tranexamic Acid); E1UOL152H7 (Iron)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009429


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[PMID]:29376603
[Au] Autor:Komyakov BK; Guliev BG; Novikov AI; Yagubov KK
[Ad] Endereço:Department of Urology, I.I. Mechnikov North-Western State Medical University, Saint-Petersburg, Russia.
[Ti] Título:[Results of open and laparoscopic partial nephrectomy for localized renal cancer].
[So] Source:Urologiia;(6):91-95, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To compare the results of laparoscopic and open partial nephrectomy. MATERIALS AND METHODS: From February 2000 to June 2016, 178 patients (mean age 58.2 years) with stage T1 kidney tumors underwent partial nephrectomy. This cohort included 106 (59.5%) men and 72 (40.5%) women. Open partial nephrectomy was performed in 102 (57.3%) patients (group 1) and laparoscopic partial nephrectomy (LPL) - 76 (42.7%, 2nd group). The majority (92.2%) of patients underwent resection for elective and 14 (7.8%) for absolute indications. Preoperatively, 163 (91.6%) and 15 (8.4%) patients had stage T1a stage T1b, respectively. The tumor size ranged from 2.4 to 6.2 cm and from 2 cm to 5.4 cm in group 1 and 2, respectively. A comparative analysis included operative time, warm ischemia time, blood loss, duration of drainage and the length of hospital stay. RESULTS: Open partial nephrectomy was associated with shorter operative time (105 min versus 125 min) and warm ischemia time (14.5 vs. 20.8 min) compared with laparoscopic partial nephrectomy. Laparoscopic partial nephrectomy was characterized by a smaller blood loss (180 ml vs. 365 ml, p<0.05) and a shorter length of hospital stay (2.5 days vs. 5.6 days, p<0.05). One patient from each group was found to have positive surgical margins. CONCLUSION: Currently, laparoscopic partial nephrectomy is the method of choice for stage T1 kidney tumors. Despite the comparatively longer operative time and warm ischemia time, laparoscopic partial nephrectomy leads to faster patient recovery and fewer complications.
[Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica/prevenção & controle
Neoplasias Renais/cirurgia
Rim/cirurgia
Laparoscopia/métodos
Nefrectomia/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Rim/patologia
Neoplasias Renais/patologia
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE


  3 / 14926 MEDLINE  
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[PMID]:29268649
[Au] Autor:Yurttas T; Filipovic M
[Ad] Endereço:1 Klinik für Anästhesie, Intensiv-, Rettungs- und Schmerzmedizin des Kantonsspitals St. Gallen.
[Ti] Título:Strategien zum Umgang mit antithrombotischen Medikamenten im perioperativen Umfeld..
[So] Source:Ther Umsch;74(7):361-367, 2017.
[Is] ISSN:0040-5930
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica/prevenção & controle
Fibrinolíticos/administração & dosagem
Fibrinolíticos/efeitos adversos
Complicações Pós-Operatórias/induzido quimicamente
Complicações Pós-Operatórias/prevenção & controle
Hemorragia Pós-Operatória/induzido quimicamente
Hemorragia Pós-Operatória/prevenção & controle
[Mh] Termos MeSH secundário: Esquema de Medicação
Medicina Baseada em Evidências
Seres Humanos
Monitorização Intraoperatória/métodos
Hemorragia Pós-Operatória/diagnóstico
Hemorragia Pós-Operatória/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Fibrinolytic Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1024/0040-5930/a000927


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[PMID]:29343222
[Au] Autor:Liu B; Li Y; Li T; Lin Y; Ma W; Lu L
[Ad] Endereço:State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China.
[Ti] Título:Transscleral tunnel incision related arterial hemorrhage in 23-gauge Vitrectomy: case report.
[So] Source:BMC Ophthalmol;18(1):9, 2018 Jan 17.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transscleral tunnel incisions are commonly made to avoid postoperative leakage in small gauge sutureless vitrectomy. We present an unreported intraoperative complication, tunnel incision related arterial hemorrhage from sclerotomy, in 23-gauge (23G) vitrectomy. CASE PRESENTATION: Two cases of intraocular arterial hemorrhage from superonasal sclerotomy were observed at the beginning of vitrectomy. The bleeding filled the vitreous cavity quickly and gushed out from the incision port after the involved supronasal cannula was removed. The active bleeding seemed not to stop spontaneously. We controlled the active bleeding by relocating the involved cannula, elevating the intraocular pressure and compressing the sclera wound. Post-operative intraocular hemorrhage from the sclerotomy was not found in any of the two cases. CONCLUSIONS: We suggest that the bleeding was from injured ciliary artery when the incision crossed 3 or 9 o'clock accidently. Surgeons might avoid this complication by locating the superior incisions away from the horizontal axis, and should be aware the proper management.
[Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica
Artérias Ciliares/lesões
Perfurações Retinianas/cirurgia
Esclera/cirurgia
Esclerostomia/efeitos adversos
Lesões do Sistema Vascular/complicações
Vitrectomia/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Hemostasia Cirúrgica/métodos
Seres Humanos
Pressão Intraocular
Masculino
Microcirurgia/efeitos adversos
Meia-Idade
Perfurações Retinianas/diagnóstico
Técnicas de Sutura/instrumentação
Tomografia de Coerência Óptica
Lesões do Sistema Vascular/diagnóstico
Lesões do Sistema Vascular/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0677-6


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[PMID]:29428029
[Au] Autor:Postlewait LM; Ethun CG; McInnis MR; Merchant N; Parikh A; Idrees K; Isom CA; Hawkins W; Fields RC; Strand M; Weber SM; Cho CS; Salem A; Martin RCG; Scoggins C; Bentrem D; Kim HJ; Carr J; Ahmad S; Abbott D; Wilson GC; Kooby DA; Maithel SK
[Ti] Título:The Hand-Assisted Laparoscopic Approach to Resection of Pancreatic Mucinous Cystic Neoplasms: An Underused Technique?
[So] Source:Am Surg;84(1):56-62, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pancreatic mucinous cystic neoplasms (MCNs) are rare tumors typically of the distal pancreas that harbor malignant potential. Although resection is recommended, data are limited on optimal operative approaches to distal pancreatectomy for MCN. MCN resections (2000-2014; eight institutions) were included. Outcomes of minimally invasive and open MCN resections were compared. A total of 289 patients underwent distal pancreatectomy for MCN: 136(47%) minimally invasive and 153(53%) open. Minimally invasive procedures were associated with smaller MCN size (3.9 vs 6.8 cm; P = 0.001), lower operative blood loss (192 vs 392 mL; P = 0.001), and shorter hospital stay(5 vs 7 days; P = 0.001) compared with open. Despite higher American Society of Anesthesiologists class, hand-assisted (n = 46) had similar advantages as laparoscopic/robotic (n = 76). When comparing hand-assisted to open, although MCN size was slightly smaller (4.1 vs 6.8 cm; P = 0.001), specimen length, operative time, and nodal yield were identical. Similar to laparoscopic/robotic, hand-assisted had lower operative blood loss (161 vs 392 mL; P = 0.001) and shorter hospital stay (5 vs 7 days; P = 0.03) compared with open, without increased complications. Hand-assisted laparoscopic technique is a useful approach for MCN resection because specimen length, lymph node yield, operative time, and complication profiles are similar to open procedures, but it still offers the advantages of a minimally invasive approach. Hand-assisted laparoscopy should be considered as an alternative to open technique or as a successive step before converting from total laparoscopic to open distal pancreatectomy for MCN.
[Mh] Termos MeSH primário: Cistadenoma Mucinoso/cirurgia
Laparoscopia Assistida com a Mão
Pancreatectomia
Neoplasias Pancreáticas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Perda Sanguínea Cirúrgica/prevenção & controle
Feminino
Laparoscopia Assistida com a Mão/métodos
Seres Humanos
Laparoscopia/métodos
Tempo de Internação
Masculino
Meia-Idade
Pancreatectomia/métodos
Estudos Retrospectivos
Fatores de Risco
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


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[PMID]:29424975
[Au] Autor:López-Vera EA; Reynosa-Oviedo Y; Treviño-Báez JD; Martínez-Salazar GJ; González-Díaz OA; Cortés-Flores R
[Ti] Título:[Subsequent reoperation obstetric hysterectomy and selective ligation of hypogastric arteries].
[Ti] Título:Reintervención posterior a histerectomía obstétrica y ligadura selectiva de arterias hipogástricas..
[So] Source:Ginecol Obstet Mex;84(9):562-6, 2016 Sep.
[Is] ISSN:0300-9041
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:Background: Bleeding in pregnancy, childbirth or postpartum period is an emergency. Selective internal iliac (hypogastric) arteries ligation is a surgical therapy in selected cases of obstetric massive hemorrhage. It had proven to be safe. Objetive: To evaluate the risk for re-intervention for post-operatory bleeding in patients with obstetric hysterectomy and selective hypogastric arteries ligation. Material and method: Cross-sectional study including women diagnosed with obstetric hysterectomy with and without selective arterial ligation as a factor to assess the risk of re-intervention, from December 2013 to December 2014, at High Specialty Medical Unit 23 of Gynaecology and Obstetrics, in Monterrey, which is a tertiary care medical center. Those patients with 28 weeks of gestation or more were selected. The postoperative blood loss was quantified by open drainage system (Penrose). Results: We performed 88 hysterectomies in the study period. We included 45 women according to selection criteria. The average was 31.9 ± 5.48 years old. Performing a selective hypogastric arteries ligation may be a protective factor (p<0.05) for re-intervention as a consequence of postoperative bleeding. Conclusion: Selective arterial ligation is a factor that could help to prevent a re-intervention. A continuous training of physicians and residents of Gynecology and Obstetrics is essential to ensure the reduction in morbidity and maternal mortality.
[Mh] Termos MeSH primário: Histerectomia/métodos
Artéria Ilíaca/cirurgia
Hemorragia Pós-Parto/cirurgia
[Mh] Termos MeSH secundário: Adulto
Perda Sanguínea Cirúrgica
Estudos Transversais
Feminino
Seres Humanos
Ligadura
Gravidez
Reoperação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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[PMID]:29424510
[Au] Autor:Solórzano-Vázquez JF; Hernández-Higareda S; Segura-Zavala JM; OsegueraTorres LF; De la Rosa-Hernández SS
[Ti] Título:[Blood loss and use of blood products in cases of cesarean hysterectomy for placenta accrete].
[Ti] Título:Pérdida sanguínea e indicación de hemoderivados en pacientes con cesárea-histerectomía por acretismo placentario..
[So] Source:Ginecol Obstet Mex;84(8):491-7, 2016 08.
[Is] ISSN:0300-9041
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:Background: Placenta accreta (abnormal insertion of the placenta or part of the myometrium ) endangers the lives of pregnant women. It is a public health problem because it can be complicated by obstetric hemorrhage , the latter being the main cause of maternal death worldwide. Objetive: To estimate the blood loss and the use of blood products in patients who underwent cesarean ­ hysterectomy for placenta accreta. Material and methods: A descriptive study was conducted in HGO UMAE CMNO IMSS in patients who underwent cesarean ­ hysterectomy for placenta accreta in a period of 4 years. Results: 106 cases of placenta accreta were studied, 23% had a massive bleeding of > 3000 cc. Packed red blood cells were transfused in 68% of events, fresh frozen plasma in platelet concentrates 29% and 6%. The history of uterine curettage was observed in 64 % and cesarean section 1 or 2 occasions in 76 % of cases. Conclusion: An early detection of placenta accreta in patients with risk factors to avoid emergency surgery is desired. Being prepared with blood products and appropriate use is a cornerstone in the management of this condition. The average blood loss was determined in cases of accreta in cesarean hysterectomy was 2523 milliliters.
[Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica
Cesárea/métodos
Histerectomia/métodos
Placenta Acreta/cirurgia
[Mh] Termos MeSH secundário: Adulto
Transfusão de Sangue/métodos
Feminino
Seres Humanos
México
Gravidez
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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[PMID]:29390259
[Au] Autor:Wang S; Shi N; You L; Dai M; Zhao Y
[Ad] Endereço:Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
[Ti] Título:Minimally invasive surgical approach versus open procedure for pancreaticoduodenectomy: A systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);96(50):e8619, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Minimally invasive pancreaticoduodenectomy (MIPD) remains one of the most challenging abdominal procedures. Safety and feasibility remain controversial when comparing MIPD with open pancreaticoduodenectomy (OPD). The aim of this systematic review and meta-analysis was to evaluate the feasibility and safety of MIPD versus OPD. METHODS: A systematic review of the literature was performed to identify studies comparing MIPD and OPD. Postoperative complications, intraoperative outcomes and oncologic data, and postoperative recovery were compared. RESULTS: There were 27 studies that matched the selection criteria. Totally 1306 cases of MIPD and 5603 cases of OPD were included. MIPD was associated with a reduction in postoperative hemorrhage (odds ratio [OR] 1.60; 95% confidence interval [CI] 1.03-2.49; P = .04) and wound infection (OR 0.44, 95% CI 0.30-0.66, P < .0001). MIPD was also associated with less estimated blood loss (mean difference [MD] -300.14 mL, 95% CI -400.11 to -200.17 mL, P < .00001), a lower transfusion rate (OR 0.46, 95% CI 0.35-0.61; P < .00001) and a shorter length of hospital stay (MD -2.95 d, 95% CI -3.91 to -2.00 d, P < .00001) than OPD. Meanwhile, the MIPD group had a higher R0 resection rate (OR 1.45, 95% CI 1.18-1.78, P = .0003) and more lymph nodes harvested (MD 1.34, 95% CI 0.14-2.53, P = .03). However, the minimally invasive approach proved to have much longer operative time (MD 71.00 minutes; 95% CI 27.01-115.00 minutes; P = .002) than OPD. Finally, there were no significant differences between the 2 procedures in postoperative pancreatic fistula (P = .30), delayed gastric emptying (P = .07), bile leakage (P = .98), mortality (P = .88), tumor size (P = .15), vascular resection (P = .68), or reoperation rate (P = .11). CONCLUSIONS: Our results suggest that MIPD is currently safe, feasible, and worthwhile. Future large-volume, well-designed randomized controlled trials (RCT) with extensive follow-up are awaited to further clarify this role.
[Mh] Termos MeSH primário: Laparoscopia
Pancreaticoduodenectomia/métodos
[Mh] Termos MeSH secundário: Perda Sanguínea Cirúrgica/estatística & dados numéricos
Transfusão de Sangue/estatística & dados numéricos
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Pancreaticoduodenectomia/efeitos adversos
Complicações Pós-Operatórias
Procedimentos Cirúrgicos Operatórios
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008619


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[PMID]:29320978
[Au] Autor:Lim CS; Dhutia A; Riga C; Dharmadasa A; Gibbs RGJ; Hamady MS
[Ad] Endereço:1 Regional Vascular Unit, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
[Ti] Título:Two-Vessel Branched Stent Graft for Severely Angulated Aortic Arch Aneurysm in a Jehovah's Witness.
[So] Source:Vasc Endovascular Surg;52(2):154-158, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Aneurysmal disease involving the origins of supra aortic vessels often requires complex open and/or endovascular repair that is not only associated with significant risk of mortality and morbidity but also often with perioperative blood loss requiring transfusion. We report a successful repair of a large thoracic aortic aneurysm (TAA) involving the aortic arch with a custom-made Bolton Relay 2-vessel branched thoracic aortic endograft in a 42-year-old Jehovah's Witness who would otherwise be very unlikely to survive an open repair. Branched thoracic aortic endografting offers a potentially safe, minimally invasive, and effective alternative for TAA disease involving the supra-aortic arteries, especially in patients who are at high risk of open surgery.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Perda Sanguínea Cirúrgica/prevenção & controle
Implante de Prótese Vascular/instrumentação
Prótese Vascular
Procedimentos Endovasculares/instrumentação
Testemunhas de Jeová
Religião e Medicina
Stents
[Mh] Termos MeSH secundário: Adulto
Angiografia Digital
Aneurisma da Aorta Torácica/diagnóstico por imagem
Aortografia/métodos
Transfusão de Sangue
Angiografia por Tomografia Computadorizada
Seres Humanos
Masculino
Desenho de Prótese
Resultado do Tratamento
Recusa do Paciente ao Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417747426


  10 / 14926 MEDLINE  
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[PMID]:28470638
[Au] Autor:Pape A; Ippolito A; Warszawska J; Raimann F; Zacharowski K
[Ti] Título:[Management of Massive Intraoperative Blood Loss Using a Case Study].
[Ti] Título:Management des massiven intraoperativen Blutverlusts anhand eines Fallbeispiels..
[So] Source:Anasthesiol Intensivmed Notfallmed Schmerzther;52(4):288-296, 2017 Apr.
[Is] ISSN:1439-1074
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Massive intraoperative bleeding is a major and potentially life-threatening complication during surgical procedures. The lethal triade of hemorrhagic shock with metabolic acidosis, hypothermia and coagulopathy enhances bleeding tendency. Avoiding this vitious circle requires a well-structured and standardized procedure. Primary goals include the maintenance of adequate tissue oxygenation, restauration of proper coagulatory function, normothermia and homeostasis of acid-base and electrolyte balance. In the present article, these therapeutic goals and their pathophysiological background are illustrated with a clinical case example.
[Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica/prevenção & controle
Substitutos Sanguíneos/administração & dosagem
Transfusão de Sangue/métodos
Monitorização Intraoperatória/métodos
[Mh] Termos MeSH secundário: Transfusão de Sangue Autóloga
Estudos de Casos e Controles
Seres Humanos
Masculino
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Blood Substitutes)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-102821



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